Diarrhoea impact indicator for water and sanitation performance

Q. I remember that some consensus has developed about best indicators for measuring impacts on diarrhoeal disease. If I remember correctly it was asking about the number and type of people (especially children under 5) in the family who have had loose stools in the previous two weeks. Do you have more info on this?
(IRC staff member)

Answer: In 1999 the Academy for Educational Development (AED) developed the following impact indicator for USAID water and sanitation programmes:

Percentage of children less than 36 months of age with diarrhoea in the last two weeks

This indicator is the period prevalence of diarrhoea based on the two-week recall of the child's primary caretaker (usually the mother). It is defined as the proportion of children in a given sample who have diarrhea at the time the information is collected or who have had it anytime in the two preceding weeks. Diarrhoea is defined as more than three loose stools passed in a twenty-four hour period. Age is calculated in completed months at the time the information
is collected from the caretaker. A child who is 20 days old is considered zero months of age, and a child of 50 days is considered one month old.

Source: Bendahmane, D.; Billig, P. and Swindale, A. (1999). Water and sanitation indicators measurement guide. Washington, DC, USA, Academy for Educational Development. http://www.fantaproject.org/downloads/pdfs/watsan.pdf

The World Health Organization (WHO) has developed “Indicators to improve children's environmental health”, which include mortality, morbidity and recurrence rates for diarrhoeal diseases.

The WHO indicator for diarrhoea morbidity is:

Incidence of diarrhoea morbidity in children aged 0-4 years.

Terms and concepts

Diarrhoea: three or more watery stools in a 24-hour period, a loose stool being one that would take the shape of the container (WHO 1996), or local definition of diarrhoea.

Episode of diarrhoea: An episode of diarrhoea begins with a 24-hour period with three or more loose or watery stools. An episode of diarrhoea isconsidered to have ended after 48 hours without three or more loose watery stools within a 24-hour period.

Incidence of diarrhoea morbidity: total number of episodes of diarrhoea during a 1-year period amongst the children surveyed.

Total population of children aged 0-4 years: number of children less than five years of age in the survey, at the time of survey.